Burkina Faso Ensures Essential Medicines Reach the Front Line

Meike Schleiff of the Department of International Health, The JHU Bloomberg School of Public Health has explored how Burkina Faso manages to get essential medicines, including those for malaria, to the front line health services. She explains that the World Health Organization (WHO) has determined essential medicines to be, “those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.”(WHO, 2018) These medicines should be available as part of health systems functioning to all persons at appropriate amounts, affordable costs, quality standards and sufficient information assured to consumers. Every country develops an essential drug list,

Essential Medicines in
Burkina Faso are purchased and distributed primarily through the Centrale
d’Achats des Médicaments Essentiels (CAMEG), or Central Purchasing of Essential
Drugs system.(CAMEG, 2018)
This CAMEG system operates with two agencies in Ouagadougou, and then has seven
additional agencies in other zones of the country (see map). From the zonal
agencies, the CAMEG supplies 67 District Dispatching Depots (DRDs), and also
supplies University Hospital Centers, regional hospitals, and additional
services provided by the Ministry of Health. For the private sector, the CAMEG
manages supplies for NGOs, faith-based organizations, medical laboratories,
pharmaceutical companies, and the Global Fund for HIV, tuberculosis, and
malaria.(CAMEG, 2018)

Before the CAMEG was created, access to essential medicines
and supplies was very difficult, particularly for rural and other hard to reach
populations. This was due to geographical access as well as high prices for
specialty drugs, limited availability of generic drugs, and prohibitive
regulations against the introduction of generic medicines. In response to this
situation, the CAMEG was created under a presidential decree in 1992 and
commenced activities in 1994. In 1997, an evaluation was carried out to determine
the impact of the CAMEG and decide whether to continue the activities through a
long-term structure; the results of this evaluation proposed establishing a
legally and financially autonomous non-profit entity to carry forward the work
of the CAMEG.(CAMEG, 2018)
Today, the CAMEG manages the selection of drug suppliers for the country,
ensures compliance with WHO and national regulations on price and quality, and
facilitates distribution and storage of drugs across the country. A full
product list of the drugs managed by the CAMEG can be found on their website (www.cameg.com).

Medicines Reach Front-Line Health Facility

Community Level

The
availability of essential generic medicines at health and social welfare
centres in Burkina Faso is 74.5%, compared with an average of 40% across the
African region and less than 60% globally.(World
Health, 2016, Ministry of Health, 2010) For hospitals, rates are slightly
lower with 61% of generics available and regional hospital centers and 39% at
university hospital centers (Saouadogo
and Compaore, 2010), but only 1.2% of branded medicines;
this situation results in patients who are referred to hospitals from lower
level facilities often being forced to purchase medicines from more expensive
private pharmacies in order to receive the necessary care at higher levels of
the health system.(Vervoort,
2012)

While immense
progress has been made in ensuring affordability and accessibility of essential
medicines in Burkina Faso, mark-ups at different points along the supply chain
still result in prohibitively high prices at final points of sale; patients
still pay for 37% of the cost of essential medicines and remain the single greatest
healthcare cost for households in Burkina and a burden for the majority of the
population who still live on less than $1.25 per day.(Vervoort,
2012)

https://t.co/yKKsmAEpSv @MinSanteRDC #Ebola 23 May 2019: Since beginning of epidemic, cumulative number of cases is 1,888, of which 1,800 confirmed 88 are probable. In total, there were 1,254 deaths (1,166 confirmed and 88 probable) and 492 people cured. 11 new confirmed cases